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Community-Acquired Pneumonia (CAP)

Pathway Background and Objectives

CCommunity-Acquired Pneumonia (CAP) is one of the most common pediatric diagnoses, responsible for approximately 2 million outpatient visits and 124,000 hospitalizations annually. In 2011, the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America released a new practice guideline with evidence-based recommendations for the management of CAP in otherwise healthy infants and children. Due to decreasing S. pneumoniae resistance, there is less need for broad-spectrum antibiotics to treat CAP. The new guidelines reflect this change in antimicrobial resistance. There is also evidence to suggest the usage of procalcitonin and its role in determining antibiotic need, as well as the utility of MRSA nasal PCR to determine the need for MRSA coverage. The objectives of this pathway are to:

The objectives of this pathway are to:

  • Decrease variation in antibiotic usage
  • Decrease unnecessary use of broad spectrum antibiotics
  • Decrease unnecessary use of azithromycin
  • Optimize ampicillin/amoxicillin dosing for local pneumococcal resistance
  • Decrease antibiotic usage to shortest effective duration

Algorithm

Download CAP Pathway Algorithm Updated September 28, 2021

Quality Metrics

  • Percentage of patient with pathway order set usage
  • Percentage of patients with appropriate antibiotics per pathway recommendations
  • Percent of patients with appropriate discharge antibiotics (prescriptions)
  • Average duration (days) of antibiotic coverage (inpatient and discharge antibiotic combined)
  • Average length of stay (days)
  • Percentage patients who had a CBC, who also had procalcitonin drawn
  • Percentage of patients with a procalcitonin level ≤0.25 who receive an antibiotic
  • Percentage of patients with negative MRSA PCR, and vancomycin or linezolid discontinued

Educational Module

Download CAP Educational Module Updated September 28, 2021

Key References:

Pathway Contacts

  • Jennifer Girotto, PharmD
  • Grace Hong, APRN
  • Ilana Waynik, MD

Disclaimer

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.

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